Dollar for dollar, we're paying more and getting less than most of our friends and relatives in Europe, some areas of the Middle East and parts of Asia. Why is that?

Those who think we don't need to improve quality -- just reduce expenses -- should think again. Look at our competition. Consider the countries -- such as Costa Rica and Saudi Arabia -- that, according to WHO, are doing a better job of meeting the health care needs of their citizens.

Of course, this is little to do with the quality and quantity of our research, just delivery. Nor does it take into consideration the existence of something like the National Institutes of Health, or the National Library of Medicine, or the Centers for Disease Control and Prevention (all government funded and run).